General High Alert Medication: This medication bears a heightened risk of causing significant patient harm when it is used in error. **BEERS Drug** Genetic Implications: Pronunciation:
Trade Name(s) Ther. Class. antidiabetics Pharm. Class. sulfonylureas PO Control of blood sugar in type 2 diabetes mellitus when diet therapy fails. Requires some pancreatic function. Action Therapeutic Effect(s): Lowering of blood sugar in diabetic patients. Absorption: Well absorbed following oral administration; micronized forms have better absorption. Distribution:
Reaches high concentrations in bile and crosses the placenta. Metabolism and Excretion: Mostly metabolized by the liver (primarily by CYP2C9). Half-life: 10 hr. TIME/ACTION PROFILE (hypoglycemic activity)
Contraindication/PrecautionsContraindicated in:
Use Cautiously in:
Adverse Reactions/Side EffectsDerm: ERYTHEMA MULTIFORME, photosensitivity, exfoliative dermatitis, rash Endo: hypoglycemia F and E: hyponatremia GI: constipation, cramps, diarrhea, drug-induced hepatitis, dyspepsia, ↑ appetite, nausea, vomiting Hemat: APLASTIC ANEMIA, agranulocytosis, hemolytic anemia, leukopenia, pancytopenia, thrombocytopenia Metabolic: ↑ weight Neuro: dizziness, drowsiness, headache, weakness * CAPITALS indicate
life-threatening. InteractionsDrug-Drug
Route/DosageThe non-micronized formulation (Diabeta) cannot be used interchangeably with the micronized formulation (Glynase PresTab) PO (Adults): DiaBeta (non-micronized)– 2.5–5 mg once daily initially (range 1.25–20 mg/day). Glynase PresTab (micronized)– 1.5–3 mg/day initially (range 0.75–12 mg/day; doses >6 mg/day should be given as divided doses). Increments should not exceed 1.5 mg/wk. PO Geriatric Patients: DiaBeta (non-micronized)– 1.25–2.5 mg/day initially; may be ↑ by 2.5 mg/day weekly. Glynase PresTab (micronized)– 0.75–3 mg/day; may be ↑ by 1.5 mg/day weekly. Availability (generic available)Tablets: 1.25 mg, 2.5 mg, 5 mg Micronized tablets: 1.5 mg, 3 mg, 6 mg In Combination with: metformin (Glucovance); see combination drugs. Assessment
Lab Test Considerations: Monitor serum glucose and glycosylated hemoglobin (HbA1C ) periodically during therapy to evaluate effectiveness.
Toxicity and Overdose: Overdose is manifested by symptoms of hypoglycemia. Mild hypoglycemia may be treated with administration of oral glucose. Severe hypoglycemia should be treated with IV D50W followed by continuous IV infusion of more dilute dextrose solution at a rate sufficient to keep serum glucose at approximately 100 mg/dL. Potential Diagnoses
Implementation
Patient/Family Teaching
Evaluation/Desired OutcomesControl of blood glucose levels without the appearance of hypoglycemic or hyperglycemic episodes. glyBURIDE is a sample topic from the Davis's Drug Guide. To view other topics, please log in or purchase a subscription. Nursing Central is an award-winning, complete mobile solution for nurses and students. Look up information on diseases, tests, and procedures; then consult the database with 5,000+ drugs or refer to 65,000+ dictionary terms. Complete Product Information. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide?Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)? Monitor blood glucose closely, and look for signs of hypoglycemia.
Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?Only short-acting insulin is used for correction of hyperglycemia. Subcutaneous absorption of insulin is reduced in DKA because of dehydration; therefore, using intravenous routes is preferable. SC use of the fast-acting insulin analog (lispro) has been tried in pediatric DKA (0.15 U/kg q2h).
Which one of the following methods techniques will the nurse use when giving insulin to a thin person?Thin individuals or children can use short needles or may need to pinch the skin and inject at a 45° angle to avoid an intramuscular injection, especially in the thigh area. Routine aspiration (i.e., drawing back on the injected syringe to check for blood) is not necessary (13).
When a client is in diabetic ketoacidosis the insulin that would be administered immediately is?In DKA, we recommend using intravenous (IV) bolus of regular insulin (0.1 u/kg body weight) followed by a continuous infusion of regular insulin at the dose of 0.1u/kg/hr. The insulin infusion rate in HHS should be lower as major pathophysiological process in these patients is severe dehydration.
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